• MeSH
• bakteriologie * dějiny   MeSH
• dějiny 19. století MeSH
• dějiny 20. století MeSH
• Escherichia coli MeSH
• terminologie jako téma MeSH
• významné osobnosti MeSH
• Yersinia pestis MeSH
• Check Tag
• dějiny 19. století MeSH
• dějiny 20. století MeSH

BACKGROUND: Lung ultrasonography (LUS) is a point-of-care imaging modality with growing potential in primary care. OBJECTIVES: While its use is well established in hospital settings, data on its accuracy when performed by general practitioners (GPs) remain limited. This study aimed to assess the diagnostic accuracy of LUS conducted by GPs following structured training. METHODS: We recruited 17 GPs from various regions of the Czech Republic. They completed a two-day educational course focused on LUS. Patients with current dyspnoea (NYHA II-IV) or a history of dyspnoea within the last four weeks were included and underwent LUS to assess the presence of pleural effusion and interstitial syndrome. An independent expert sonographer, blinded to clinical data, evaluated recorded LUS video loops as the reference standard. LUS findings were categorized into A profile (presence of A lines and intact lung sliding, indicating normal aeration), B profile (three or more B lines per intercostal space in at least two intercostal spaces per hemithorax, suggesting interstitial syndrome), pulmonary consolidation and pleural effusion. RESULTS: A total of 128 patients were enrolled in the study. A total of 768 thoracic segments were examined. A profile was identified in 642 (83.6%) segments, B profile in 108 (14.1%), pulmonary consolidation in 8 (1.0%), and pleural effusion in 12 (1.6%). For the identification of A profile, the sensitivity was 97.51% (95% CI 95.98-98.57), and the specificity was 88.10% (95% CI 81,13-93,18); for B profile, the sensitivity was 87.04% (95% CI 79,21-92,73), and the specificity was 97.73% (95% CI96,28-98,72); for pulmonary consolidation, the sensitivity was 100.0% (95% CI 63,06-100,00), and the specificity was 100.0% (95% CI 99,52-100,0); for pleural effusion, the sensitivity was 83.33% (95% CI 51,59-97,91), and the specificity was 99.87% (95% CI 99,27-100,00). CONCLUSION: Our findings provide important preliminary data, demonstrating that GPs can perform LUS accurately after a structured training program. THE TRIAL REGISTRATION IDENTIFIER: is NCT04905719.

• MeSH
• dospělí MeSH
• dyspnoe diagnostické zobrazování   MeSH
• intersticiální plicní nemoci diagnostické zobrazování   MeSH
• klinické kompetence MeSH
• lidé středního věku MeSH
• lidé MeSH
• pleurální výpotek diagnostické zobrazování   MeSH
• plíce * diagnostické zobrazování   MeSH
• plicní nemoci * diagnostické zobrazování   MeSH
• praktičtí lékaři * výchova   MeSH
• primární zdravotní péče MeSH
• průřezové studie MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• ultrasonografie MeSH
• vyšetření u lůžka * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Česká republika MeSH

At a population level, the European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter and Microbiota Study Group (EHMSG), and the European Society of Pathology (ESP) suggest endoscopic screening for gastric cancer (and precancerous conditions) in high-risk regions (age-standardized rate [ASR] > 20 per 100 000 person-years) every 2 to 3 years or, if cost-effectiveness has been proven, in intermediate risk regions (ASR 10-20 per 100 000 person-years) every 5 years, but not in low-risk regions (ASR < 10).ESGE/EHMSG/ESP recommend that irrespective of country of origin, individual gastric risk assessment and stratification of precancerous conditions is recommended for first-time gastroscopy. ESGE/EHMSG/ESP suggest that gastric cancer screening or surveillance in asymptomatic individuals over 80 should be discontinued or not started, and that patients' comorbidities should be considered when treatment of superficial lesions is planned.ESGE/EHMSG/ESP recommend that a high quality endoscopy including the use of virtual chromoendoscopy (VCE), after proper training, is performed for screening, diagnosis, and staging of precancerous conditions (atrophy and intestinal metaplasia) and lesions (dysplasia or cancer), as well as after endoscopic therapy. VCE should be used to guide the sampling site for biopsies in the case of suspected neoplastic lesions as well as to guide biopsies for diagnosis and staging of gastric precancerous conditions, with random biopsies to be taken in the absence of endoscopically suspected changes. When there is a suspected early gastric neoplastic lesion, it should be properly described (location, size, Paris classification, vascular and mucosal pattern), photodocumented, and two targeted biopsies taken.ESGE/EHMSG/ESP do not recommend routine performance of endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET)-CT prior to endoscopic resection unless there are signs of deep submucosal invasion or if the lesion is not considered suitable for endoscopic resection.ESGE/EHMSG/ESP recommend endoscopic submucosal dissection (ESD) for differentiated gastric lesions clinically staged as dysplastic (low grade and high grade) or as intramucosal carcinoma (of any size if not ulcerated or ≤ 30 mm if ulcerated), with EMR being an alternative for Paris 0-IIa lesions of size ≤ 10 mm with low likelihood of malignancy.ESGE/EHMSG/ESP suggest that a decision about ESD can be considered for malignant lesions clinically staged as having minimal submucosal invasion if differentiated and ≤ 30 mm; or for malignant lesions clinically staged as intramucosal, undifferentiated and ≤ 20 mm; and in both cases with no ulcerative findings.ESGE/EHMSG/ESP recommends patient management based on the following histological risk after endoscopic resection: Curative/very low-risk resection (lymph node metastasis [LNM] risk < 0.5 %-1 %): en bloc R0 resection; dysplastic/pT1a, differentiated lesion, no lymphovascular invasion, independent of size if no ulceration and ≤ 30 mm if ulcerated. No further staging procedure or treatment is recommended.Curative/low-risk resection (LNM risk < 3 %): en bloc R0 resection; lesion with no lymphovascular invasion and: a) pT1b, invasion ≤ 500 μm, differentiated, size ≤ 30 mm; or b) pT1a, undifferentiated, size ≤ 20 mm and no ulceration. Staging should be completed, and further treatment is generally not necessary, but a multidisciplinary discussion is required. Local-risk resection (very low risk of LNM but increased risk of local persistence/recurrence): Piecemeal resection or tumor-positive horizontal margin of a lesion otherwise meeting curative/very low-risk criteria (or meeting low-risk criteria provided that there is no submucosal invasive tumor at the resection margin in the case of piecemeal resection or tumor-positive horizontal margin for pT1b lesions [invasion ≤ 500 μm; well-differentiated; size ≤ 30 mm, and VM0]). Endoscopic surveillance/re-treatment is recommended rather than other additional treatment. High-risk resection (noncurative): Any lesion with any of the following: (a) a positive vertical margin (if carcinoma) or lymphovascular invasion or deep submucosal invasion (> 500 μm from the muscularis mucosae); (b) poorly differentiated lesions if ulceration or size > 20 mm; (c) pT1b differentiated lesions with submucosal invasion ≤ 500 μm with size > 30 mm; or (d) intramucosal ulcerative lesion with size > 30 mm. Complete staging and strong consideration for additional treatments (surgery) in multidisciplinary discussion.ESGE/EHMSG/ESP suggest the use of validated endoscopic classifications of atrophy (e. g. Kimura-Takemoto) or intestinal metaplasia (e. g. endoscopic grading of gastric intestinal metaplasia [EGGIM]) to endoscopically stage precancerous conditions and stratify the risk for gastric cancer.ESGE/EHMSG/ESP recommend that biopsies should be taken from at least two topographic sites (2 biopsies from the antrum/incisura and 2 from the corpus, guided by VCE) in two separate, clearly labeled vials. Additional biopsy from the incisura is optional.ESGE/EHMSG/ESP recommend that patients with extensive endoscopic changes (Kimura C3 + or EGGIM 5 +) or advanced histological stages of atrophic gastritis (severe atrophic changes or intestinal metaplasia, or changes in both antrum and corpus, operative link on gastritis assessment/operative link on gastric intestinal metaplasia [OLGA/OLGIM] III/IV) should be followed up with high quality endoscopy every 3 years, irrespective of the individual's country of origin.ESGE/EHMSG/ESP recommend that no surveillance is proposed for patients with mild to moderate atrophy or intestinal metaplasia restricted to the antrum, in the absence of endoscopic signs of extensive lesions or other risk factors (family history, incomplete intestinal metaplasia, persistent H. pylori infection). This group constitutes most individuals found in clinical practice.ESGE/EHMSG/ESP recommend H. pylori eradication for patients with precancerous conditions and after endoscopic or surgical therapy.ESGE/EHMSG/ESP recommend that patients should be advised to stop smoking and low-dose daily aspirin use may be considered for the prevention of gastric cancer in selected individuals with high risk for cardiovascular events.

• MeSH
• biopsie MeSH
• časná detekce nádoru * metody   normy   MeSH
• gastroskopie * normy   MeSH
• hodnocení rizik MeSH
• infekce vyvolané Helicobacter pylori komplikace   MeSH
• lidé MeSH
• nádory žaludku * patologie   diagnóza   terapie   MeSH
• prekancerózy * patologie   diagnóza   terapie   MeSH
• společnosti lékařské MeSH
• žaludeční sliznice patologie   diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• Geografické názvy
• Evropa MeSH

Pleuroparenchymal fibroelastosis (PPFE) is a rare fibrotic lung disease with a poor prognosis. Some patients with PPFE have prominent lesions in one upper lobe. Due to the unilateral nature of lesions, similarities between some patients of PPFE and unilateral upper field pulmonary fibrosis (unilateral upper-PF) have been indicated. A 55-year-old man was referred to our hospital with PPFE, which had developed dyspnea 9 months previously. He had undergone resection of renal cancer 64 months prior to the onset of PPFE. He was administered the antifibrotic drug nintedanib, but passed away due to respiratory failure 43 months after the onset. What were impressive points in the clinical course of this PPFE patient was the similarity to unilateral upper-PF, including his medical history, and the poor prognosis. Although very rare, we do believe that the information on medical history and progression in this patient might provide suggestion into the treatment of future patients with a similar trajectory.

• MeSH
• fatální výsledek MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní fibróza * diagnóza   patologie   MeSH
• počítačová rentgenová tomografie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

In the first months of the Spanish Civil War, the Spanish doctor Frederic Duran Jordà developed a new method of blood transfusion which overcame the era of direct arm-to-arm transfusions. While Duran was experimenting in Barcelona and the Aragon front, hundreds of foreign doctors came to Spain with the help of internationalist associations and offered their services to the Republican government. The Czechoslovak Dr Karel Holubec entered Spain in May 1937 and practiced in a mobile hospital funded by the Czechoslovak Committee to Aid Democratic Spain, receiving blood from Duran's laboratory. This article aims to study how Duran and Holubec transferred the method of blood transfusion to Czechoslovakia through interpersonal contact, conferences, and performances. This paper argues that while individual actors played a crucial role in the diffusion of medical practices, this circulation was determined by a unique historical and socio-political framework. The Spanish Civil War, the International Brigades, and the invasion of Czechoslovakia by Nazi Germany were not only the historical context of medical innovation but an integral part of it.

• MeSH
• dějiny 20. století MeSH
• krevní transfuze * dějiny   metody   MeSH
• lidé MeSH
• Check Tag
• dějiny 20. století MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• historické články MeSH
• Geografické názvy
• Československo MeSH
• Španělsko MeSH

Na akutní urologickou ambulanci se dostavil 93letý pacient stěžující si na obtékající permanentní močový katétr a bolesti podbřišku. Mezi pro případ relevantní pacientovy diagnózy patřily velmi vysoce rizikový uroteliální karcinom močového měchýře po opakovaných transuretrálních resekcích a recentně také výplaších intravezikální chemoterapií, diabetes mellitus druhého typu na dvojkombinaci perorálních antidiabetik a recidivující močové infekce. Pro suspekci na perforaci močového měchýře či komunikaci močového měchýře se střevem, při sterkorálně zapáchající moči, bylo doplněno kontrastní CT s vylučovací fází a CT cystogram. Perforaci či píštěl jsme neprokázali, avšak na základě zobrazovacích vyšetření jsme stanovili diagnózu emfyzematózní cystitidy. Tato kazuistika má za cíl upozornit na tuto vzácnou, mnohdy nenápadně se projevující, avšak potenciálně život ohrožující urologickou nosologickou jednotku.

A 93-year-old male presented to the urology outpatient clinic with complaints of a leaking indwelling urinary catheter and suprapubic pain. Our patient had a history of urothelial carcinoma of the bladder, for which he has undergone multiple transurethral resections and recent intravesical chemotherapy instillations. He also has type 2 diabetes mellitus, which is managed with a combination of oral antidiabetic medications and has a history of recurrent urinary tract infections. A CT scan with contrast and an excretory phase and CT cystogram were performed to rule out bladder perforation or a bladder-bowel fistula in the presence of foul-smelling urine. The CT scan did not show any evidence of colo-vesicalor fistula, but it did show evidence of emphysematous cystitis. This case report aims to highlight this rare, often presenting in a subtle manner, but life-threatening urological disease.

• Klíčová slova
• emfyzematózní cystitida,
• MeSH
• antibakteriální látky farmakologie   terapeutické užití   MeSH
• aplikace intravezikální MeSH
• cystitida * diagnóza   farmakoterapie   terapie   MeSH
• diabetes mellitus 2. typu farmakoterapie   komplikace   MeSH
• diagnostické zobrazování metody   MeSH
• Escherichia coli patogenita   MeSH
• hypoglykemika farmakologie   terapeutické užití   MeSH
• karcinom z přechodných buněk chirurgie   farmakoterapie   MeSH
• lidé MeSH
• nádory močového měchýře * chirurgie   farmakoterapie   MeSH
• senioři nad 80 let MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

INTRODUCTION: The term "post-COVID-19 syndrome" describes a range of symptoms persisting beyond the acute phase of the disease. These symptoms predominantly include fatigue, muscle pain, shortness of breath, and psychological issues. Research additionally suggests the possibility of long-term neurological and psychiatric impairment associated with COVID-19. METHODOLOGY: The study included patients who visited the post-COVID outpatient clinic between April 2020 and June 2022. The examination included the detailed history taking, including the COVID-19 course, posteroanterior chest X-ray and pulmonary function tests. Anxiety level was assessed using the Beck Anxiety Inventory (BAI). The relationship between anxiety, demographic data, and course of the disease, need for hospital admission during the acute phase, oxygen therapy, post-inflammatory changes on the chest X-ray and lung function parameters was investigated. RESULTS: This study included 1756 patients who experienced COVID-19 and visited a post-COVID outpatient clinic. The majority of individuals experienced a mild form of the infection. The results showed that younger age and female gender were associated with significantly higher anxiety scores. Inpatients had lower BAI values than those who were not hospitalized during acute phase. Patients with post-inflammatory changes on chest X-ray had surprisingly lower BAI values. Lower values of FEV1 (forced expiratory volume in 1 second), DLCO (diffusing capacity of the lungs for carbon monoxide), and KCO (carbon monoxide transfer coefficient) were associated with significantly higher BAI values. Female gender was associated with higher levels of anxiety. In contrast, higher FEV1 values reduced the risk of a pathological level of anxiety. CONCLUSION: In our study, the influence of age, gender, inpatient care during the acute phase of infection, the presence of post-inflammatory changes on the chest diagram and selected parameters of lung function (FEV1, DLCO, and KCO) were shown to be important factors in the assessment of anxiety symptoms in post-COVID patients.

• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• Chirurgie, ortopedie, traumatologie,
• MeSH
• neurochirurgie MeSH

• NLK Obory
• neurochirurgie

BACKGROUND: Changes in both the vascular system and brain tissues can occur after a prior episode of coronavirus disease 2019 (COVID-19), detectable through modifications in diffusion parameters using magnetic resonance imaging (MRI) techniques. These changes in diffusion parameters may be particularly prominent in highly organized structures such as the corpus callosum (CC), including its major components, which have not been adequately studied following COVID-19 infection. Therefore, the study aimed to evaluate microstructural changes in whole-brain (WB) diffusion, with a specific focus on the CC. METHODS: A total of 101 probands (age range from 18 to 69 years) participated in this retrospective study, consisting of 55 volunteers and 46 post-COVID-19 patients experiencing neurological symptoms. The participants were recruited from April 2022 to September 2023 at the Institute for Clinical and Experimental Medicine in Prague, Czech Republic. All participants underwent MRI examinations on a 3T MR scanner with a diffusion protocol, complemented by additional MRI techniques. Two volunteers and five patients were excluded from the study due to motion artefacts, severe hypoperfusion or the presence of lesions. Participants were selected by a neurologist based on clinical examination and a serological test for COVID-19 antibodies. They were then divided into three groups: a control group of healthy volunteers (n=28), an asymptomatic group (n=25) with a history of infection but no symptoms, and a symptomatic group (n=41) with a history of COVID-19 and neurological symptoms. Symptomatic patients did not exhibit neurological symptoms before contracting COVID-19. Diffusion data underwent eddy current and susceptibility distortion corrections, and fiber tracking was performed using default parameters in DSI studio. Subsequently, various diffusion metrics, were computed within the reconstructed tracts of the WB and CC. To assess the impact of COVID-19 and its associated symptoms on diffusion indices within the white matter of the WB and CC regions, while considering age, we employed a statistical analysis using a linear mixed-effects model within the R framework. RESULTS: Statistical analysis revealed a significant difference in mean diffusivity (MD) between the symptomatic and control groups in the forceps minor (P=0.001) and CC body (P=0.003). In addition to changes in diffusion, alterations in brain perfusion were observed in two post-COVID-19 patients who experienced a severe course. Furthermore, hyperintense lesions were identified in subcortical and deep white matter areas in the vast majority of symptomatic patients. CONCLUSIONS: The main finding of our study was that post-COVID-19 patients exhibit increased MD in the forceps minor and body of the CC. This finding suggests a potential association between microstructural brain changes in post-COVID-19 patients and reported neurological symptoms, with significant implications for research and clinical applications.

• Publikační typ
• časopisecké články MeSH